Free Sensing Light by Mark A. Jacobson

bedecked in a white flounce shirt and a blue bandana that couldn’t contain his thick red hair. A policeman recognized the pirate, called him “Doc,” and cordoned off space for him to work. Kevin pulled down Robert’s pants, carefully inserted his bare thumb and forefinger into Robert’s wound, and pinched the artery. The bleeding stopped.
    Marco was amazed by Kevin’s equanimity as he was helping EMTs lift Robert into an ambulance while keeping a firm hold on the artery and reassuring Marco that his friend would be fine. Kevin talked the driver into letting Marco ride with them. In the ambulance, Marco got Kevin’s phonenumber. The following evening, Marco brought over an expensive Medoc which they had just begun to explore when other appetites took precedence.
    Driving west on the Bay Bridge, Kevin tried to soothe himself. He envisioned the panorama they had seen at the top of the trail. That failed to calm him. The brief telephone call had put him in red alert mode. Kevin had become the local expert on immune deficiencies at City Hospital. Everyone would expect him to provide definitive guidance on what tests to perform and what medications to administer to this patient.
    Kevin tried harder to imagine the scene before his pager beeped. He wondered how he and Marco might have looked to a passing stranger. Did their physical differences make them an odd couple? Would a passer-by be repelled by seeing them kiss? Furious for having that last thought, Kevin pounded the dashboard. How could he allow a scintilla of the old self-hatred back into his consciousness? Why couldn’t he shed it? He was living in San Francisco now. Being gay was totally acceptable here. What was his problem?

II
    D ANA P EARLSTEIN, A PETITE junior resident, pushed a somnolent man on a gurney toward the only unoccupied bed in City Hospital’s intensive care unit. Dana had two months of experience leading a medicine team and was twenty-six hours into her on-call shift. Her impeccable make-up remained intact, but her confidence, appropriately tenuous at this point in her training, was waning, especially with her last admission. She’d heard rumors the patient had a lot of clout in local politics, and he was gravely ill.
    Once Dana saw Kevin enter the ICU, her hunched-up shoulders relaxed. Kevin looked at the toothpaste-advertisement smile she gave him, the thin man asleep on the gurney, the familiar intravenous solutions, portable cardiac monitor, and oxygen tank, then back to Dana’s smile. He calmed down.
    As Dana was handing admission orders to an ICU clerk, Kevin grabbed her stethoscope and took over wheeling the patient to his room. He signaled Dana that he would return in a moment. Kevin noticed a scaly rash on the man’s forehead, a severe type of dandruff common in Gay-Related Immune Deficiency, and the hollow shape of his temples, a sign of muscle wasting. The man didn’t react to Kevin’s calling out his name.
    â€œMr. Miller,” Kevin said shaking him gently, “Are you OK?”
    â€œI don’t know,” the patient mumbled.
    Further questioning revealed he was disoriented to place and time. Kevin listened to his heart and lungs, felt his abdomen, flexed his neck, and used a tongue blade and penlight to look inside his mouth. In addition to the patient’s confusion, there was another abnormality. A white layer, like thinly spread cottage cheese, covered the roof of his mouth.
    Kevin sat down at the ICU conference table with Dana and her medical student, and she launched into her case presentation—an account of Mr. Miller’s symptoms and history, her physical exam findings, the laboratoryand x-ray results, and finally her formulation of a differential diagnosis and plan of action.
    â€œMr. Miller is a forty-two year old white male with no prior hospitalizations or chronic diseases. He works as an assistant to the mayor of San Francisco and lives alone in the